18 senior claims examiner jobs found

Come join one of America’s fastest-growing insurance companies. Since 1848, National Life Group has aimed to keep our promises, providing families with stability in good times and in bad. Throughout that history, we have provided peace of mind to those families as they plan their futures. Our mission extends beyond the insurance and annuities policies that we offer. We strive to make the world a better place through our grants from our charitable foundation, paid volunteer time for our employees, environmentally sustainable and healthy workplaces, and events that promote the work of nonprofits in our own backyard. We foster a collaborative environment with opportunities for growth and encourage our associates to live our values: Do good. Be good. Make good. Please note that we do not offer visa sponsorship for this position. Summary The Claims Associate is responsible for reviewing documents received for all Life and Annuity claims, and adjudicating the claim in...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This position is onsite in Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic...

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our  journey as we strive to transform the insurance  carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our  internal and external communities better everyday! Learn more...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a hybrid position located in Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or...

The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.  Clinical and/or technical expertise is utilized to address the provision of medical care and to identify inappropriate billing practices and errors inclusive of, but not limited to; duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with  diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance General Liability Claims Examiner Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?   Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected...

Company: Mercer Description: We are seeking a talented individual to join our Career Consulting team at Mercer as a Summer Analyst. This role will be based in Houston, TX or Dallas, TX. This is a hybrid role that has a requirement of working at least three days a week in the office. Mercer is uniquely qualified to help organizations design and execute sophisticated workforce strategies, whether it’s for a multinational organization or a local company attempting to grow within its market. We provide best-in-class consulting, rigorous analytics, and data-driven insights that help organizations make fact-based decisions.   As a Summer Analyst on Mercer’s Career team, you will support client engagements across industries as an integral member of project teams. You’ll help diagnose client challenges and contribute to the design of strategic talent solutions across Rewards, HR Transformation, Talent Strategy, Workforce Planning & Analytics, and Communications. The role...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Liability Claims Examiner | General Liability, Premise Liability & Litigation Experience | TX Licensing Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who represent virtually every...

The Claims Assistant will support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific customer needs. This is a hybrid position reporting to Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless), and input notes/diary entries in the claims system Process payments, as needed Process form letters, state forms and reports Assist claims examiners with telephone calls including provider, claimant and customer calls Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent written and verbal communication skills PC literate, including Microsoft Office (Word, Excel) Ability to work independently and in a team environment Strong organizational skills   EDUCATION & EXPERIENCE:  High school diploma, college degree preferred Six (6) months of...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Jurisdictions: TX, OK, & LA | Licensing: TX/FL preferred (Plano, TX/Remote) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who represent...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Jurisdiction: TX, OK, & LA | Licensing: TX/FL preferred (Plano,TX/Remote) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Non-Subscriber Claims Examiner - General Liability | Jurisdiction: TX | Licensing: TX/FL preferred (Hybrid - Plano,TX/Remote) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Liability (Hybrid Schedule - TX or WI) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most...

The Appeals Team Lead assists injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling a consistent, timely delivery of our quality services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receive incoming calls, emails and faxes from the Medical Access Assistant line Communicate clearly and professionally with providers and other stakeholders via phone and email Provide excellent customer service...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be an acknowledged technical expert in Markel Claims, responsible for resolving claims posing the highest exposure to the company. The position will have significant autonomy. The position will act as a leader and resource to other examiners and managers in the Casualty Claims division and will provide legal and claims support to the Casualty underwriting business partners. Job Responsibilities Manage a full case load of the most complex/high exposure claims within Casualty Claims...

Position Summary The Property and Casualty Underwriter is responsible for managing a portfolio of accounts and driving new and renewal business opportunities for Property and Casualty insurance. The role assesses risks associated with insuring properties and liabilities, evaluates applications, analyzes data, and determines coverage terms and premiums to ensure sound underwriting decisions. They develop and maintain underwriting practices and guidelines as per delegated authority and build relationships with brokers and other stakeholders in the designated portfolio. What will your job entail? Job Responsibilities: • Underwrites new and renewal property and casualty business, analyzes policy forms, broker endorsement requests, and submitted documentation as per company underwriting standards and guidelines and obtains additional information as needed. • Determines whether to accept, modify or decline a risk through evaluation of the coverage value, location, usage, safety...

Position Summary The Upstream Energy Underwriter is responsible for managing a portfolio of accounts and driving new and renewal business opportunities. The role assesses risks associated with insuring properties and liabilities, evaluates applications, analyzes data, and determines coverage terms and premiums to ensure sound underwriting decisions. They develop and maintain underwriting practices and guidelines as per delegated authority and build relationships with brokers and other stakeholders in the designated portfolio. What will your job entail? Job Responsibilities: • Underwrites new and renewal upstream energy business, analyzes policy forms, broker endorsement requests, and submitted documentation as per company underwriting standards and guidelines and obtains additional information as needed. • Determines whether to accept, modify or decline a risk through evaluation of the coverage value, location, usage, safety features, and other factors pertinent to the...